Diagnostic accuracy of T and N stages with endoscopy, stomach protocol CT, and endoscopic ultrasonography in early gastric cancer.
BACKGROUND
Preoperative accurate diagnosis of the T and N stages in early gastric cancer (EGC) is important in determining the application of various limited treatments. The aim of this study is to analyze the accuracy of T and N staging of EGC with esophagogastroduodenoscopy (EGD), Stomach protocol CT (S-CT), and endoscopic ultrasonography (EUS), and the factors influencing the accuracy.


METHODS
Four hundred and thirty-four patients preoperatively diagnosed as EGC using EGD or S-CT and undergoing curative gastrectomy at Seoul National University Hospital in 2005 were included. The T and N stage reviewed by experienced personnel were compared with the surgical pathology.


RESULTS
The predictive values for EGC of EGD, S-CT, and EUS were 87.4%, 92.2%, and 94.1%, respectively. The predictive values for node negativity of S-CT, and EUS were 90.1% and 92.6%, respectively. The factors leading to underestimation of T stage with EGD were the upper third location, the size greater than 2 cm, and diffuse type of tumor. Those with S-CT were female sex, the upper third location and lesion size greater than 2 cm.


CONCLUSIONS
Before applying limited treatment for EGC, a surgeon should consider the risk factors of underestimation of T stage with EGD or S-CT.
Ahn
Hye Seong
HS
Department of Surgery, Seoul National University College of Medicine, Jongno-Gu, Seoul, Korea.
Lee
Hyuk-Joon
HJ
Yoo
Moon-Won
MW
Kim
Sang Gyun
SG
Im
Jong Pil
JP
Kim
Se Hyung
SH
Kim
Woo Ho
WH
Lee
Kuhn Uk
KU
Yang
Han-Kwang
HK
D000328:Adult; D000368:Aged; D004384:Duodenoscopy; D016145:Endoscopy, Digestive System; D019160:Endosonography; D004945:Esophagoscopy; D005260:Female; D005743:Gastrectomy; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed